Under general direction, obtain appropriate reimbursement levels for professional and facility services by reviewing and coding medical procedures, diagnoses and physician visits. Analyze denial and rejection reports, and appeal wherever appropriate. Provide information and direction to the physicians and other providers relevant to coding. Submit charges to UCPG and UCMC in a timely manner.
1) Professional and Facility Fee Abstracting and Coding: Ensure that the professional and facility components of services are processed and billed in a timely manner in order to obtain payments appropriate for the department.
2) Review and abstract the patientâ™s medical chart for services performed by attending physicians and other providers.
3) Assign the appropriate ICD-9/10CM and CPT-4 codes to the services provided by attending physicians and other providers.
4) Process charges prior to submission to UCPG/UCMC.
5) Assure that charges are submitted in a timely manner in order to meet deadlines.
6) Coding Integrity & Compliance: Provide educational direction to physicians, administrators, support staff, hospital personnel and other providers as requested.
7) Provide regular feedback to physicians and support staff to improve on success and reduce errors.
8) Assure that documents are completed according to UCMC and other regulatory policies.
9) Recommend systemic changes and work with faculty and staff members to facilitate such change.
10) Payment Analysis: Assist manager in reviewing, correcting and appealing, insurance denials for professional and facility services.
11) Review delinquent accounts and work with UCPG/UCMC to obtain additional demographic and insurance information as necessary.
1) Demonstrated ability to interact and communicate with clarity, tact, and courtesy with patrons, patients, staff, faculty, students, and others.
2) Demonstrated ability to participate as a member of the staff in identifying priorities for the work unit and participate as a member of a work group or team.
3) Demonstrated ability to work with supervision to identify and describe work task priorities.
4) Demonstrated ability to communicate effectively in English, both orally and in writing.
5) Demonstrated ability to recognize and resolve or refer problems and conflicts.
6) Demonstrated ability to negotiate and manage interpersonal communication effectively.
7) Demonstrated ability to use or learn to use a range of position-related software applications. These may include standard software packages as well as networked systems, e-mail, the Web, and other types of information structures.
8) Demonstrated ability to read and understand basic documentation such as Help screens and departmental handouts.
1) High School diploma or GED is required.
Technical Knowledge or Skills:
1) Thorough working knowledge of medical terminology validated by testing or certification required.
2) Thorough working knowledge of ICD-9/10CM and CPT-4 coding systems as demonstrated by certification through a nationally accredited body (e.g., AAPC, AHIMA) is required.
3) Thorough working knowledge of federal and state regulations regarding reimbursement is required.
4) Comprehensive knowledge of third party payer rules, procedures and policies, and upcoming trends in all areas of billing and collection is required.
5) Expertise in decision making and accountability, creativity, and ability to recommend new procedures and implementation of said procedures is required.
6) PC experience which includes spreadsheet, word processing, presentation and database software is required.
7) Familiarity with electronic billing and medical records systems (i.e., EPIC, IDX and Centricity) is required.
1) Resume required.
(NOTE: When applying, all required documents MUST be uploaded under the Resume/CV section of the application)
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Staff Job seekers in need of a reasonable accommodation to complete the application process should call 773-702-5800 or submit a request via the Applicant Inquiry Form.
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